Individual provider Active NPI

Deava Chestnut, RN

  • Certified Registered Nurse Anesthetist
  • Little River, SC
National Provider Identifier
1477129336
Registry record updated Jul 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
26253 Issued in SC
Practice address
4000 Highway 9 E
Little River, SC 29566-7833
Phone
(803) 434-7000
NPI assigned
Jun 1, 2021
Last updated
Jul 1, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 26253 SC Primary
Student in an Organized Health Care Education/Training Program 390200000X SC

Addresses

Primary practice location

4000 Highway 9 E
Little River, SC 29566-7833

Mailing address

4000 Highway 9 E
Little River, SC 29566-7833
Phone (910) 840-2690

Electronic endpoints 2

TypeEndpointUseAffiliation
Other URL Columbia
CONNECT URL mcleodhealth.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220831001165 SC Practitioner - Certified Registered Nurse Anesthetist (Crna) 5890179485 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
McLeod Physician Associates IIGroup PAC ID 8224031307, 541 clinicians

Practice addresses (Care Compare)

3655 Mitchell St
Loris, SC 29569-2827
Phone (843) 777-7000

800 E Cheves St
Florence, SC 29506-2650

800 E Cheves St
Florence, SC 29506-2652

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse, Registered Nurse

State licenses

LicenseStateTypeSpecialty
26253SCMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
McLeod Physician Associates II CurrentSince Jul 26, 2022 Accepting new patients
McLeod Physician Associates II CurrentSince Jul 26, 2022 Accepting new patients

Locations

800 E Cheves St
Ste 240
Florence, SC 29506
Phone (843) 777-7950

800 E Cheves St
Ste 480A
Florence, SC 29506
Phone (843) 777-7337

4000 Highway 9 E
Little River, SC 29566
Phone (843) 390-8100

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1622505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656633600000",
    "number": "1477129336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4000 HIGHWAY 9 E",
            "city": "LITTLE RIVER",
            "state": "SC",
            "postal_code": "295667833",
            "telephone_number": "910-840-2690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4000 HIGHWAY 9 E",
            "city": "LITTLE RIVER",
            "state": "SC",
            "postal_code": "295667833",
            "telephone_number": "803-434-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHESTNUT",
        "first_name": "DEAVA",
        "name_prefix": "Mrs.",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-01",
        "last_updated": "2022-07-01",
        "certification_date": "2022-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "SC",
            "license": "26253",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "SC",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Columbia",
            "affiliation": "N",
            "endpointDescription": "N/A",
            "address_1": "5 Richland Medical Park Dr",
            "city": "Columbia",
            "state": "SC",
            "country_code": "US",
            "postal_code": "292036863",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "mcleodhealth.org",
            "affiliation": "N",
            "endpointDescription": "Hospital",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "4000 Highway 9 E",
            "city": "Little River",
            "state": "SC",
            "country_code": "US",
            "postal_code": "295667833",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Little River, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.